Another holiday away from home

I knew, going in to medicine, that there would be holidays that I missed, ones I just couldn't be there for. In the (not quite) 2 years I have had the initials MD after my name, this has been true on more than one occasion. Here is a brief list:

• Valentine's 2007
• My Anniversary 2006
• New Year's Eve and Day 06-07 and 07-08
• Easter 2007 and 2008

Not to mention some Memorial Days, and a few other minor holidays. However, I have been home for both Thanksgiving Days and Christmas Days the past two years. Honestly, I really can't complain. Being gone is just sort of part and parcel for the job. However, what really has impacted me is just how amazing my family has been about all of this. Today, again, my children heard their friends talking about their Easter Egg hunt, without being able to talk about their own. But they don't utter a single complaint. Birthday celebrations have had to be adjusted a day or so here and there. Other celebrations have been bumped as Daddy had to go to the hospital. But they don't seem to care. I'm sure that, at some level, they do care. I am sure it is tough at times. However, they deal with it with amazing grace and poise. They actually seem to see it as exciting that they have theirs the day after (or before, as the case may be). Most of us know (all of us should know) that there will be similar sacrifices. And our families should know this as well. But talking about it is one thing, actually starting residency and living it is another. Now, a few years in to it, I can say that, like having children, no one can tell you what it will be like. Sometimes families struggle with this. And while it hasn't always been easy on us, I am humbled to realize just how supportive my family has been through this all. They are pretty amazing.

I passed!

Please refer to the previous post to fully understand my excitement. It is sufficient to say that I passed my stone. Hooray. I just have some vague lingering discomfort in my back, but nothing like it was. Thank goodness. Carry on.

A healthy dose of empathy

The time quickly approaches. I really only have a few months left as a General Surgery resident. Then I make the transition to Urology resident. To be quite honest, I am incredibly excited. Not only am I incredibly tired of General Surgery, I look forward to focusing my time and energy on what I will be practising for the rest of my life. But yesterday I gained a whole new ability to empathize with my future patients. It was about 8:45 in the morning. I was working on writing some transfer orders for one of our patients. Getting ready to move her out of the ICU, I sat down at the desk with a pile of forms (we can't seem to do anything without forms) and started to write. Then it hit me. Pain. Pain like nothing I have ever experienced. In my right flank. It radiated down, around the side and to my left groin. Maybe that is too much information. Oh well, there it is. I couldn't sit still. Walking hurt, sitting hurt. Anything I did hurt. I knew exactly what it was. I had a kidney stone. I paged the chief resident on our service and told him I thought I had a stone. After I told him my symptoms he agreed. Time to go to the ER. About 30-40 minutes had passed and it was just getting worse. I walked down to the ER, hobbling a bit, and went to the check in desk. They gave me a funny look, here I was, in my scrubs and white coat, embroidered with "Peter J Jones MD" right there on the front. The triage nurse called my name and immediately looked at me with a quizical look. "What are you doing here?" she asked. Yeah, we know each other. See, the General Surgery resident is in the ER a lot. Seeing consults, running traumas, etc. They get to know us pretty well. "I think I have a stone," I told her. I mentioned the symptoms and she took me right to a room. I won't lie, they took really good care of me. Sort of that "care for our own" attitude. The nurse was in immediately, and IV was in my arm along with 30 mg of Toradol. They even went and got me a mobile IV pole, since I just couldn't stand to sit still. A few minutes passed, things were getting worse and I called the nurse back in. "I'm ready for the morphine," I said. He pulled the syringe out of his pocket and I had 4 mg of morphine on board. Holy crap, that is good stuff. I didn't get a buzz (I don't think you really can when you are in real pain), but I felt a lot better. All this happened before the ER doc had even seen me. Honestly, the nurses and aides were great. I gave them a urine sample, and within minutes I was on the table of the CT scanner. I walked back to my room (walking was still preferable to holding still) and grabbed a C.O.W. (computer on wheels), logged in to the medical record system, and pulled up my own CT scan. Maybe there is some HIPAA violation in there. Frankly, I didn't care. I just wanted to know if there truly was a stone or not. As I scroll down the scan, I spot one. A little 2-3 mm white kidney stone. But there was one problem. This was in the upper pole of my left kidney, no the right, where the pain was. I look over at the right side and notice that the right renal pelvis is dilated. So is the right ureter. That means there is something further down the line. I keep scrolling through the scan and sure enough, there it is. Another 2-3 mm stone in the right junction of the ureter and the bladder. Great. Well, at least I knew why I hurt so bad. At least I knew it was real. A few more doses of morphine, a prescription for ibuprofen (the 800 mg tablets) and some Percocet, and a couple of liters of IV fluid later and I was headed home. The pain continued, off and on the rest of the day and into the night. As it is right now, the pain is better, but I still haven't caught that little bugger in my strainer. I have puked a couple of times (first time since High School), and didn't really sleep at all last night. Hopefully tonight will be better. At least I don't hurt nearly as bad. Next time I have a patient with a kidney stone, now I can truly empathize with them. I suppose that is good. Right?